Boots on the ground brought out last-minute Latino ACA signups

A last-minute shift to more community and local outreach along with other grass-roots marketing strategies helped state exchanges and enrollment organizations boost Latino signups just before the March 31 deadline after months of lagging enrollment in Obamacare plans.

California's Latino enrollment rose to 32% of those enrolling in healthcare coverage during the first three weeks of March, nearly twice what it was during the first three months of open enrollment when only about 18% of those signing up for insurance identified themselves as Latino. The increase came because of major policy shifts decided upon in January, a state official said. Latinos made up about 60% of California's uninsured before open enrollment began.

One of those changes was increasing Latino marketing by 73% from January to March. Covered California also enhanced its Spanish-language website, added opportunities for in-person enrollment, and increased the number of bilingual certified enrollment counselors and certified insurance agents. There are now more than 5,000 of those in the state who speak Spanish.

“Many people needed multiple touches before they understood their options and felt prepared to choose the plan that was right for them and their family,” Covered California executive director Peter Lee said. “They needed in-person help from agents, certified counselors, county workers or Covered California's customer service staff to help them with their enrollment.”

In Florida, where 10% of the country's eligible uninsured Hispanics live, many of the state's federally qualified community health centers were inundated with people wanting to get enrolled during the final week.

“They were quite, quite busy,” said Andrew Behrman, president and CEO of the Florida Association of Community Health Centers. “The appropriate word was hectic.”

Centers in Tampa were assisting with open enrollment had planned to open from 11 a.m. to 4 p.m. on Saturday. By 8 a.m., Behrman said, there was a line out the door, and they didn't shut down until 10 p.m. before reopening Sunday morning.

Behrman speculated that marketing efforts to let people know time was running out may have served as an impetus for some to enroll in the eleventh hour. But he also emphasized the need that many had to sit down in person for explanations of the law from one of the organization's 400 counselors, particularly in a state where the government didn't promote the act.

Texas also felt the handicap of an unsupportive state government.

“The climate was not very good. The leadership in Austin did nothing to inform people about the ACA,” said Al Ortiz, communications coordinator for the Texas Organizing Project, which operates a statewide campaign known as Access to Affordable and Quality Health Care. “Organizations like us and our allies had to try to get people informed.”

The Texas Organizing Project relied on telethon-style phone banks through Univision and Telemundo, canvassers, workshops and enrollment events. In March, the final month of open enrollment, the group hosted signup events in Houston, Dallas and San Antonio that attracted nearly 1,000 people. The Texas Organizing Project estimates that it reached nearly 700,000 Texas residents during the full enrollment period.

“We know with past campaigns engaging the Latino community on other issues, you have to build a relationship of trust and comfort before you can engage in something more robust,” said Steven Lopez, senior health policy analyst, health policy project, at Hispanic advocacy organization the National Council of La Raza

Community-based affiliates are key to those relationships, Lopez said. “The information our affiliates on the front lines relayed to us is that there was a high interest in the Latino community, but there was some fear for immigration purposes. It took a while for those myths to be debunked,” Lopez said.

“There's a marked improvement from where the states started in October,” Lopez said. “But without the community-based organizations and their continued investment, I don't think it would have been successful.”

Correction: In the article "Boots on the ground brought out last-minute Latino ACA signups" (April 7, 2014), quotes from Steven Lopez, senior health policy analyst, health policy project, at Hispanic advocacy organization the National Council of La Raza were mistakenly attributed to Ricky Garza, the organization's communications coordinator. This has been corrected above.